Description

Teicoplanin, has been available for use in the UK since 1991. In contrast to vancomycin, nephrotoxicity does not occur if measured serum concentrations exceed those expected and this has been cited as one reason for not recommending therapeutic drug monitoring (TDM) when using teicoplanin. Knowledge of the pharmacodynamic parameters indicate that pre-dose concentrations and the ratio of serum concentrations/MIC are important for predicting outcome and evidence to support the use of TDM in serious infection has been accumulating in recent years. In contrast to the UK data-sheet, which advises maintaining a pre-dose concentration of >10mg/L it is now accepted that concentrations of >20mg/L are required for effective treatment of staphylococcal endocarditis and septic arthritis. This approach may also be applicable in the treatment of other deep-seated infections and for some particular patient groups, however the use of TDM when using teicoplanin in other circumstances is often unnecessary.